Conservative treatment of achilles tendon rupture: a systematic review comparative with surgical treatment

Abstract

# Background Achilles tendon ruptures are common, particularly in active individuals, and significantly affect function. Controversy persists over whether conservative or surgical treatment offers superior outcomes. # Objective To compare conservative and surgical treatments for Achilles tendon rupture regarding rerupture rates, functional recovery, and complication incidence. # Methods A systematic review was conducted following PRISMA guidelines. Randomized controlled trials (RCTs) comparing conservative and surgical treatments published between 2015 and 2025 were selected using MEDLINE. Risk of bias was assessed using Cochrane RoB 2.0. # Results Eight RCTs were included. Conservative treatment showed a higher rerupture rate but fewer complications. Surgical treatment, while reducing rerupture, increased risks of nerve injuries and infections. Long-term functional outcomes were generally comparable between groups. # Conclusion Neither approach proved universally superior. Surgical repair may be preferred to prevent rerupture, but conservative treatment avoids operative complications. Clinical decisions should consider individual factors such as age, activity level, and patient preferences.